CPT 12004
Wound Repair - All Levels
Current code53 hospitals with prices
What Washington hospitals publish for this code
Medicaid (state program): Washington Apple Health fee-for-service. Applies only to Medicaid enrollees.
| Hospital | Medicaid (state program) rates (lowest – highest) | Cash price | List price (before discounts) |
|---|---|---|---|
| BHC Fairfax Hospital | — | $110 – $183 | $110 – $183 |
| Capital Medical Center | — | — | — |
| Cascade Medical Center | $324 – $361 | $486 – $540 | $607 – $675 |
| Cascade Valley Hospital | — | $644 | $805 |
| Coulee Medical Center | — | $199 – $423 | $222 – $470 |
| Deaconess Medical Center | — | $321 | $802 |
| EvergreenHealth Medical Center | — | $992 | $1,240 |
| EvergreenHealth Monroe | — | $780 | $975 |
| Harborview Medical Center | — | $1,387 | $1,981 |
| Highline Medical Center | — | $377 | $1,233 |
| Island Hospital | — | $158 – $343 | $158 – $343 |
| Kadlec Regional Medical Center | — | $883 | $1,261 |
| Legacy Salmon Creek Medical Center | — | $242 | $373 |
| Mary Bridge Children's Hospital | — | — | — |
| MultiCare Auburn Medical Center | — | — | — |
| MultiCare Covington Medical Center | — | — | — |
| MultiCare Good Samaritan Hospital | — | — | — |
| MultiCare Valley Hospital | — | $321 | $802 |
| Olympic Medical Center | — | $302 | $377 |
| Overlake Hospital Medical Center & Clinics | — | $758 | $1,515 |
| PeaceHealth Peace Island Medical Center | — | $242 – $527 | $373 – $811 |
| PeaceHealth Southwest Medical Cente | — | $538 – $1,020 | $828 – $1,569 |
| PeaceHealth St John Medical Center | — | $538 – $1,767 | $828 – $2,719 |
| PeaceHealth St Joseph Medical Center | — | $539 – $555 | $829 – $854 |
| PeaceHealth United General Medical Center | — | $298 – $544 | $458 – $837 |
| Prov Sacred HRT Med Ctr & Childs Hosp. | — | $474 | $677 |
| Providence Centralia Hospital | — | $578 | $1,111 |
| Providence Holy Family Hospital | — | $509 | $727 |
| Providence Mount Carmel Hospital | — | $128 – $160 | $183 – $229 |
| Providence Regional Medical Center Everett | — | $361 | $694 |
| Providence St Joseph Hospital | — | $160 – $167 | $229 – $238 |
| Providence St Mary Medical Center | — | $236 – $585 | $337 – $835 |
| Providence St Peter Hospital | — | $578 | $1,111 |
| Seattle Children's Hospital | $41.31 – $284 | $1,125 | $304 – $1,125 |
| Skagit Valley Hospital | — | $178 – $898 | $223 – $1,122 |
| St Anthony Hospital | — | $375 | $1,233 |
| St Clare Hospital | — | $356 | $1,233 |
| St Elizabeth Hospital | — | $436 | $1,233 |
| St Francis Community Hospital | — | $387 | $1,233 |
| St Joseph Medical Center | — | $409 | $1,233 |
| St Michael Medical Center | — | $544 | $1,233 |
| Swedish Edmonds Hospital | — | — | — |
| Swedish Issaquah | — | $608 | $1,266 |
| Swedish Medical Center | — | $608 | $1,266 |
| Swedish Medical Center / Cherry Hill | — | $608 | $1,266 |
| Tacoma General Allenmore Hospital | — | — | — |
| Three Rivers Hospital | |||
| University of Washington Medical Ctr | — | $956 | $1,365 |
| Virginia Mason Medical Center | — | $370 | $725 |
| Wellfound Behavioral Health Hospital | — | — | — |
| WhidbeyHealth Medical Center | — | $419 – $2,250 | $419 – $2,250 |
| Yakima Valley Memorial | — | $456 | $1,140 |
Medicare (traditional) reference
Only for people on original Medicare. These are CMS’s 2026 amounts. They aren’t what private insurance or cash patients pay.
- Doctor's fee, Seattle (King County)
- $186 in an office; $75.73 in a hospital or surgery center
- Doctor's fee, rest of Washington
- $165 in an office; $70.88 in a hospital or surgery center
- Hospital outpatient payment (national)
- $205 (APC 5051)